The Bispectral Index and Induced Hypothermia— Electrocerebral Silence at an Unusually High Temperature

Puri, G. D.; Bagchi, Aadhyaa; Anandamurthy, Balaram; Dhaliwal, RS

doi:10.1177/0310057x0303100515

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…Electrode placement is not difficult, and the device is easy to use but is subject to motion artifact, electromyographic activity, and electrical interference. Bispectral Index monitoring has been used to determine electrical silence during deep hypothermia, 22 but isoelectric EEG might not always correlate with lack of cortical activity in newborns, and falsely elevated BIS values have been reported in brain-dead patients. 23 Bispectral Index values are reported to decrease during hypothermia, 24 and anesthetic dose requirements to achieve a BIS value of 55 are decreased with hypothermic CPB.…”

Section: Electroencephalographic Monitoringmentioning

confidence: 99%

Brain Monitoring and Protection During Pediatric Cardiac Surgery

Williams

Ramamoorthy

2007

Semin Cardiothorac Vasc Anesth

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With advances in medical care, survival after cardiac surgery for congenital heart disease has dramatically improved, and attention is increasingly focused on long-term functional morbidities, especially neurodevelopmental outcomes, with their profound consequences to patients and society. There are multiple reasons for concern about brain injury. Some cardiac defects are associated with brain anomalies and altered cerebral blood flow regulation. Brain imaging studies have demonstrated that injury to gray and white matter is quite frequent before heart surgery in neonates. Cardiopulmonary bypass and deep hypothermic circulatory arrest are associated with short- and longer-term adverse neurologic outcome. Additional brain injury can occur during the patient's recovery from surgery. Strategies to optimize neurologic outcome continue to evolve. With new technological developments, perioperative neurologic monitoring of small children has become easier, and data suggest these modalities usefully identify adverse neurologic events and might predict outcome. Monitoring methods to be discussed include processed electroencephalography, near infrared spectroscopy, and transcranial Doppler ultrasound. Alternative perfusion techniques to deep hypothermic circulatory arrest have been developed, such as regional antegrade cerebral perfusion during cardiopulmonary bypass. Other neuroprotective strategies employed during open-heart surgery include temperature regulation, acid-base management, degree of hemodilution, blood glucose control and anti-inflammatory therapies. Evidence of the impact of these measures on neurologic outcome is examined, and deficiencies in our current understanding of neurologic function in children with congenital heart disease are identified.

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Section: Electroencephalographic Monitoringmentioning

confidence: 99%

Brain Monitoring and Protection During Pediatric Cardiac Surgery

Williams

Ramamoorthy

2007

Semin Cardiothorac Vasc Anesth

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Predictive value of Bispectral Index (BIS) in emergency neurosurgical patients: Loss of BIS reactivity to propofol predicts poor functional outcomes

Chan

Fung

Lui

et al. 2022

Clinical Neurology and Neurosurgery

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A comparison of the effects on bispectral index of mild vs. moderate hypothermia during cardiopulmonary bypass

Honan

Doherty

Frizelle

2006

European Journal of Anaesthesiology

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Moderate hypothermic cardiopulmonary bypass has lower bispectral index scores when compared to mild hypothermic cardiopulmonary bypass, at a steady state of inspired enflurane. This may reflect an actual increase in the depth of hypnosis. However, as this study did not address the physico-chemical changes of the volatile agent or the accuracy of the bispectral index algorithm at lower temperatures, we would not advocate a change in practice based solely on this report.

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The Bispectral Index and Induced Hypothermia— Electrocerebral Silence at an Unusually High Temperature

Cited by 4 publications

References 9 publications

Brain Monitoring and Protection During Pediatric Cardiac Surgery

Brain Monitoring and Protection During Pediatric Cardiac Surgery

Predictive value of Bispectral Index (BIS) in emergency neurosurgical patients: Loss of BIS reactivity to propofol predicts poor functional outcomes

A comparison of the effects on bispectral index of mild vs. moderate hypothermia during cardiopulmonary bypass

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